Name : Address : City : Prov/State : Postal/Zip : Name and Address where purchased : Product Purchased : Estate  Vintage  Character  Ranch Pioneered Domestic  Pioneered Exotic  Crafted Engineered  Hand Scraped Solid Sawn Size Color Reason for purchasing Vintage : What room did you install Vintage in : Family Room  Bedroom  Den  Hallway Kitchen  Living Room  Bathroom  Basement Number of residents in your home : Adults   :  Children :  Dogs :  Cats  :  Type of residence : Single  Rental  Cottage Townhouse  Condominium Age of Residence : 5 years or less  5 - 10 years 10 - 15 years  20 plus